Doc On The Run Podcast

Today's episode comes from a YouTube viewer named John, who wrote in with a question about nerve pain vs. peroneal tendon pain.    He said ”I'm experiencing discomfort in my fifth metatarsal/peroneal tendon below the ankle. There is no swelling. However, upon hamstring stretch, especially in a downward dog position, this area feels like it's on fire. The fact that I cannot do downward dog right no...

Today's question comes from one of the YouTube viewers. Tasnim, wrote in and wanted to know whether or not "stress reaction" is the same terminology that is used in the UK for the term "metatarsalgia".    This question points out how confusing these two terms can be when you have forefoot pain that might be a stress fracture, might be a plantar plate sprain, or could even be a neuroma.    Are stre...

You're out on a run, and you suddenly start having extremely sharp heel pain. You think it's plantar fasciitis.  But when you look at your foot, you see a huge bruise.    That's not plantar fasciitis. That's where you ripped something.    Is there always bruising with a partial rupture or a tear in the plantar fascia?    Well, that's what we're talking about today on the Doc On The Run Podcast.   

One of the most powerful ways to reduce stress and strain on any piece of injured tissue is to get completely off of your feet.  Bedrest can do that.  I was talking with a runner recently who asked a great question,  “Should I just do bed rest?”  I answered,  “Bed rest is like chemo for runners.” With chemotherapy, we're basically giving you a powerful drug.  But is it going to kill the tumor firs...

Today I was on a call with an injured runner who was told she had plantar fasciitis.    She was confused and she started doing some research. She enrolled in the Runner's Heel Pain Course because she was trying to figure out why her "diagnosis" didn't seem to match her gut instinct.  She suspected her diagnosis was wrong.  If you have heel pain, and you call for a ride instead of finishing your ru...

I was just on a call with a runner who has had this condition called "hallux rigidus."  and it's where your big toe joint starts to get stiff, becomes rigid, and it doesn't move as much.   Hallux rigidus is a progressive condition, especially if you continue to irritate the joint. You can damage the joint cartilage. The stiffer the big toe joint gets, the more pressure on the cartilage when the bi...

Have you ever been to the doctor and heard this, “You must be allergic to running because you get injured every time you go running.”  A recovering runner and I were on a call talking about how she could get back to running and how to "just go for a run" without getting re-injured.  We were talking about this approach of getting her running fitness back now, and returning to running faster without...

Plantar fasciitis is one of the most common conditions that affects runners. In fact, foot pain consistent with plantar fasciitis accounts for about 40% of all visits to the podiatrists in the United States each year. Unfortunately, just because you think that you have plantar fasciitis, and you started doing some simple things to treat it, it doesn't necessarily mean that it's going to get better...

I just had a discussion with a really interesting patient. He was a pro triathlete. He had some difficulty getting past a particular injury. We were talking about all of the ways that you can encounter barriers to healing. And how you can start making progress in spite of them. We were talking about two different things, logical and psychological barriers. What's the difference between logical ver...

Every runner with a stress fracture wants to know "when can I run?"  How soon you can start running after a foot fracture really depends on when you have enough strength in the bone so that the healing fracture will withstand the forces applied during running without breaking the bone again. It all depends on what you do to speed up (or slow down) the bone healing process. The rate of fracture hea...

The first thing any runner should do when you roll your ankle is protect the ankle from further injury. In fact, the algorithm doctors use to treat ankle sprains is P. R. I. C. E. P stands for Protection, meaning don’t roll it again. Don't make it worse. Then, Rest it. Ice it. Use Compression to keep it from swelling. Elevate it to get the fluid out if it's really swollen. So, what happens is, you...

There are three key indications that tell me that somebody may not have plantar fasciitis, but probably have something else. If you think you have plantar fasciitis, you may have a different form of runner's heel pain. Treating the wrong condition will not get you back to running. Understanding the ways plantar fasciitis shows up can help you make sure you don't have something else causing your he...

I got a specific question about a recent episode on calluses in runners.  The question was, “Well, if you have that pattern of callus, and reduce the thickness of the callus so the callus is going away, does that mean there is less pressure there?” You may have checked out the episode on the three callus patterns that I see in runners at high risk for getting a plantar plate injury.  Does callus r...

I was just on a call with an interesting elite athlete, and he's been injured.    He had one particular injury in his foot and then started having a completely different injury, as soon as that injury in his foot was starting to heal.   We were talking about how disappointment can lead to more and more setbacks. The phrase he used struck me.  He said, “I think it might be traumatic disappointment....

Yesterday I called a recovering runner, just to check in and see how he was doing, because he had done the Fast Track Challenge 2 months ago.    He's doing great. He has recovered and gotten past his injury.  He said he learned a lot in the Challenge and has applied it to his training.    He's on track for running ultra-marathons this year.  He has a coach. Training is in full swing with no limita...

If you are a runner and you get pain in the ball of the foot, particularly at the base of the second toe right. It could be a plantar plate sprain.    Whenever I see a runner on webcam who has pain that sounds like a plantar plate sprain, the first thing I do is look for any callus pattern in the skin that suggests they have too much pressure and friction at that area that could injure the plantar...

Everybody's short on time. This is true for runners in training, but it's also true for injured runners.  If you're trying to make progress as fast as possible, you really have to do the things that will give you the most progress in the least amount of time.    Many runners I talk to on a second opinion consultation webcam call really want to know which stretches will help them. Specifically, whi...

If you have a condition called "hallux rigidus" or "hallux limitus," the name tells you what's wrong.  "Hallux" means big toe. "Rigidus" means the big toe joint doesn't move at all. "Limitus" just means the big toe joint movement is limited and stiff. There are three problems with hallux rigidus, which are: 1) damage to the cartilage, 2) bone spurs around the joint and 3) restriction of the soft t...

Let's say you have a nagging tendon injury that's really been painful. It's been bugging you a lot when you run.  You have had persistent pain either on the side of the ankle that just won't seem to go away, even if you run less.   You see the doctor and she says, “Look, we tried everything. We should do surgery. Your tendon is not really torn, but we should do this surgical procedure called a "sy...

Let's say you're out on a trail run, you roll your ankle and sprain it. So what do you do? You limp home, you get back to the car, you ice it, you take some pressure off of it, you elevate it, you do all the right stuff. But, it's really painful and swollen the next few days. Then, maybe a day or two later, it's black, it's blue and swollen. But even worse, you look down and you're kind of dismaye...

Today's episode comes from a discussion I just had yesterday with an athlete. He had a metatarsal fracture non-union. A "fracture non-union" can develop when there is a crack in the bone that moving a little bit too much and doesn't completely heal. Non-unions can happen if you get a stress fracture, and you keep running on it and you're tough and you're strong and it doesn't really hurt that bad....

When you get an injury to a bone like a metatarsal stress fracture, you can develop a thing called a "bone callus." You might even see it as a lump visible on the x-ray in your doctors office. Whether the lump is made up of hard bone, fibrocartilage or something in between, it may help you to understand the significance of that lump in your foot. When the bone callous appears, and the size of the...

Achilles tendon injury on one leg and a calf muscle strain on the other leg?  Talk about a bummer: 2-for-the-price-of-1 overtraining injuries! Yes, it is possible to get similar running injuries on opposite legs, at the same time. Today I had a conversation with a runner who has developed both of these injuries from running. These are actually just opposite ends of the same biomechanical spectrum...

What would be worse than not being able to run because you had foot pain that didn't get better for a year or two? I know one thing that would be worse... Having foot surgery to treat a problem that was not actually even located in the foot. Think about that. You had pain in your foot for two years. Then some doctor convinces you to have surgery, only to find out there was no problem with the tend...